Snoring, a problem which afflicts millions of people and their partners, occurs when there is obstruction of the free flow of air through the passages of the back of the mouth and nose. This is most often caused by excessive tissue in the uvula and soft palate. Snoring can be a sign of a more serious condition such as sleep apnea, and patients should be evaluated by a physician. Sleep apnea is caused by a combination of a floppy uvula and soft palate and the tongue falling back to shut off the postnasal space. Surgery to correct this involves removal of the excess soft palate and uvula with uvulopalatopharyngoplasty, which is a hospital-performed operation requiring general anesthesia and a hospital stay of up to three days.
Uvulopalatoplasty, however, can be performed in doctors' offices to relieve sleep apnea and reduce snoring. Currently in use in some large metropolitan areas is laser-assisted uvulopalatoplasty. However, laser equipment can be prohibitively expensive for some practitioners. Laser surgery systems range in cost from $40,000 to $150,000. Laser surgery is not the subject of this invention. For purposes of the present invention, electrosurgical devices are contemplated. Many doctor's offices are equipped with electrosurgery instruments. The present invention is designed to be adapted to operate in conjunction with such instruments. Exemplary of such instruments are those manufactured by ConMed, Aspen Surgical Systems, Englewood, Colo.
None of the prior art electrocautery devices appear to have been designed for uvulopalatoplasty, since they are too large and unwieldy to fit easily into a patient's mouth.
U.S. Pat. Nos. 4,936,842 and 4,823,791 to Frank D. Amelio describe electrosurgical instruments for removing hemorrhoids and anal warts. Amelio '791 describes a detachable barrel. The barrel portion or "probe"described in the '791 patent is a single barrel which contrasts to the opposing jaw members of the present invention. No "snipping" action can be achieved by the Amelio device. The device of the '842 Amelio patent shows a handle mechanism to hold the detachable barrel. An important distinction between the device of the present invention and the device described by Amelio '842 is the trigger mechanism described by Amelio compared to the thumb actuator of the present invention. The thumb actuator of the present invention is an important improvement over the trigger mechanism described by Amelio. The trigger of Amelio is actuated by pulling the index finger toward the handle. The present invention describes an actuating means which allows the index finger to be free to manipulate the entire device allowing greater control by the user than if the index finger was required to operate the trigger. A thumb actuator provides an additional advantage of not requiring additional space in front of the handle for an index finger actuator/trigger and its movement. Thus, the barrel of the present invention can be shorter than in devices having an index finger trigger. Another disadvantage of an index finger trigger design is the extra care required by the surgeon when positioning the instrument in the mouth to prevent premature actuation upon contact of the instrument with the patient's mouth. If this design is equipped with a "trigger guard" to prevent such premature actuation, even less manual control is afforded the surgeon due to the limited space between the patient's jaw and the patient's uvula and soft palate where the surgeon must position the cutting jaws of the instrument. The present invention overcomes this drawback by eliminating the trigger mechanism and replacing it with a thumb actuator means placed behind the barrel which affords the surgeon the maximum amount of maneuverability possible.
U.S. Pat. No. 5,445,638 to Rydell and O'Brien describes an instrument called bipolar coagulation and cutting forceps which has not only a trigger mechanism, but also a handle having finger guides which are squeezed together like a pair of scissors to operate the forceps. A device of this configuration would afford even less manual control to the surgeon.